Clinical Physiology, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
Eur Heart J Cardiovasc Imaging. 2014 Jun;15(6):637-42. doi: 10.1093/ehjci/jet254. Epub 2013 Dec 29.
The aim of this study was to assess the feasibility and learning curve of training novice operators in using automated ultrasound to achieve satisfactory carotid intima-media thickness (CIMT) measurements.
Four novices underwent 4 weeks carotid ultrasound training using a newly developed automated ultrasonograph. A longitudinal B-mode image of the distal right common carotid artery (CCA) was acquired in 96 patients. The interoperator CIMT reproducibility was analysed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC) for every week and compared with that from an expert operator. The weekly mean CV of the measurements on the 24 patients made by all novices was consistently reduced: 0.06, 0.05, 0.03, and 0.02, respectively. For the expert, the mean CV was 0.02, 0.02, 0.03, and 0.02, respectively. The novices' standard deviation (SD) of CVs also reduced weekly from 0.04 in the first week to 0.01 in the last week (P < 0.05). The corresponding weekly variation in the SD for the expert was 0.02 for the first week to 0.01 in the last week (P = 0.27). The agreement between measurements made by the novices was expressed by the ICC being 0.97 (P < 0.001) in the first week and increased to 0.99 (P < 0.001) in the fourth week.
CIMT assessment by novices using an automated ultrasound could be reliably achievable after a short training period. These results may have encouraging implications when designing screening programmes for primary prevention in community health service.
本研究旨在评估新手操作员使用自动化超声技术进行颈动脉内膜中层厚度（CIMT）测量的可行性和学习曲线。
4 名新手操作员在 4 周内使用新开发的自动化超声仪进行颈动脉超声培训。在 96 例患者中获取右侧颈总动脉（CCA）远端的纵向 B 型模式图像。每周分析每位操作员的 CIMT 重复性，以变异系数（CV）和组内相关系数（ICC）表示，并与专家操作员的结果进行比较。所有新手操作员对 24 名患者的每周平均 CV 测量值逐渐降低：分别为 0.06、0.05、0.03 和 0.02。对于专家操作员，每周的平均值分别为 0.02、0.02、0.03 和 0.02。新手操作员 CV 的标准差（SD）每周也从第一周的 0.04 降低到最后一周的 0.01（P < 0.05）。专家操作员每周 CV 的相应变化为第一周为 0.02，最后一周为 0.01（P = 0.27）。新手操作员之间的测量一致性通过 ICC 表示，第一周为 0.97（P < 0.001），第四周增加到 0.99（P < 0.001）。
新手操作员使用自动化超声技术进行 CIMT 评估在短时间培训后可以可靠实现。这些结果在社区卫生服务中设计初级预防筛查计划时可能具有令人鼓舞的意义。
